Laura Silk and Megan Vickers

Pilates during pregnancy is not only safe for both you and baby, but also a great way to prepare your body for the many changes to come.


9 months can feel like a very long time as you are counting down the 40 weeks to meet your baby. But in fact 9 months is a very short time for the body to go through the massive changes that it does in pregnancy. As well as helping your body adapt to the growing demands of pregnancy, exercising in the right way can prepare your body for the event of giving birth and for very physical job of lifting, feeding, bathing and caring for a new-born.


In the past there has been conflicting advice around exercise in pregnancy. However current guidelines now recognise the many benefits of that exercising during pregnancy can bring. Alongside the normal exercise related cardiovascular benefits for both you and baby, exercising in pregnancy aids in prevention of back and pelvic pain and pelvic floor dysfunction, reducing the risk of gestational diabetes, post-natal depression and birth complications. Research recommends 30 minutes of moderate exercise most days or every day and even women who have not exercised before can begin exercising during their pregnancy with guidance of their healthcare professional.


At Four Sides London our ante-natal classes are tailored to what your body needs as you progress through your pregnancy. Each trimester comes with its own challenges and physical demands and we target the key areas specific to you.


First Trimester:

Although outward signs of pregnancy may not show until later in this trimester the body is going through a lot of physiological changes from the very beginning of pregnancy. There is an increase in heart rate and cardiac output from as early as 4 weeks gestation as the body supplies the foetus with oxygen and nutrients. Huge hormonal changes occur as the uterus starts to support the placenta and your growing baby which can affect digestion, reflux and more frequent trips to the bathroom. An increase in the hormone progesterone relaxes and smooth muscles, this helps our uterus to grow but also has an effect systemically. Even our blood vessels are affected and this results in a drop in blood pressure which can cause light headedness or feeling faint.


At this point it is common to experience nausea, fatigue, hormonal headaches and sickness.  Lower intensity exercise at this time can help to relieve these symptoms. Guidelines recommend not starting any new form of exercise until the second trimester, but continuing with exercise you already enjoy is perfectly safe.


From the first trimester it is a good time to start strengthening the pelvic floor muscles. As the weight of baby increases during pregnancy more load will be placed on the pelvic floor. So it is important to learn how to correctly activate these muscles early on and cope with the growing demands. Pelvic floor muscle strengthening has been shown to reduce the incidence of stress urinary incontinence and and pelvic organ prolapse post-partum. Functional pelvic floor exercises are included in all of our ante-natal Pilates classes at Four Sides. We will teach you how to activate and train your pelvic floor. If you struggle with this at all we can recommend the best intervention for you.


Second Trimester:

Often if you have felt tired and unwell in the first trimester, energy levels start to improve in the second trimester and you may feel you can do a bit more exercise- wise. During this time your baby is growing and their weight is increasing. Posture can start to change; with an increased curve in the lower back, or a sway back posture as you tuck under your bottom and try to bring baby back over your pelvis. Both can lead to low back and pelvic girdle pain (PGP). At the start of the second trimester there is also a peak in the hormone relaxin which significantly increases ligament laxity. Without sufficient strength in the muscles to compensate for this pelvic girdle pain and dysfunction can arise.


Our Strength + Conditioning for Mums and Ante-Natal Pilates classes target the key muscles which support the pelvic alignment and provide “force closure” to prevent pelvic instability. We focus on the gluteals, adductors, hamstrings, spinal muscles and deep abdominals which work together to stabilise the pelvic ring. Training these muscles as your baby grows and your body changes is recommended to preventing and alleviate PGP, especially if you have been affected by this previously.


In this trimester lying flat on your back is not recommended as the weight and position of the uterus increases pressure on your vena cava – the blood supply back to the heart. If this becomes compromised you will start to feel lightheaded, unwell and your body will warn you to change positon. From 16 weeks it is recommended to avoid or minimise time in this position. There are many other positions that we exercise in to work on strengthening the deep abdominals to help to support the pelvis and lower back, plus aiming to help the recovery of the abdominal muscles after giving birth.


Third Trimester:

You may feel more tired again in the third trimester as your baby grows rapidly and their oxygen and energy demands increase. But if there are no contraindications and you’re feeling well you can continue to exercise right up until your babys arrival!


The hormone relaxin has maximum effect in this trimester to prepare your pelvis for your baby’s birth. You may notice that all off the joints in the body will have increased laxity as relaxin affects the entire body. So injuries are more likely in this trimester, so it is a good idea to reduce the intensity of sport and exercise and switch to control and strength focused exercise.


You may feel more breathlessness due to increased pressure on the diaphragm by the growing uterus, and the increasing weight on the bladder will mean you need to urinate more frequently. There is an increase in fluid retention causing swelling in the extremities and exercise is a good way to assist circulation and prevent puffy ankles.


Another benefit of continuing to exercise throughout your pregnancy is that it helps to prepare your body for labour. In this trimester you should continue to work on pelvic floor strength but also focus on being able to fully relax the pelvic floor and open the pelvis. In classes we work through many early labour positions to help baby descend into the birth canal.


And finally you will notice that your friendship circle grows as you share experiences and interests with other mums to be. Exercise in pregnancy with other pregnant mums is well documented to improve our well being and reduce stress. This is a great side effect of exercising together, you can bond over your growing bumps and soon share baby stories.


Of course sometimes the path of this miracle is not always smooth. We can work with you on a 1:1 basis if you have been given special precautions or you have concerns. We appreciate that every pregnancy is different and everyone has had a different journey to get here.


Our specialist Four Sides London Women’s Health team are available to answer any questions. Or you can book a Pilates Intro or Women’s Health Physiotherapy Consultation and find out about the best way to get started and continue with exercising in pregnancy.